Metabolic Endotoxemia and the Gut-Brain Connection

Mold Toxicity Summit Outline of Presentation by Jill Carnahan MD ABFM, ABIHM, IFMCP

1. Toxic effects of chemotherapy can be life-long
   1. Word-finding can be writing/typing as well as verbal
   1. Current buildings have numerous porous materials, drywall, even wood, carpet, insulation all of which can harbor hidden mold once wetted; US bldg.’s more problematic than older European bldgs.
   1. Fungi are not the only culprits, Gram negative and positive, mycobacteria, parasites, numerous other microbes can be involved.
   1. Metabolic Endotoxemia;
      1. Toxins that make their way into the blood stream
         1. Endotoxins more common with Gram Negative
         1. Exotoxins more common with Gram positive
         1. Our gut microbiome has both good and bad bacteria
      1. When gut microbes and their LipoPolySacharide (LPS) coatings cross the gut wall and get into the blood stream (leaky gut) causing a massive inflammatory response
         1. Depression
         1. Anxiety
         1. Insomnia
         1. Cardiovascular disease
         1. Cancer
         1. Obesity
         1. Neurodegenerative disease
      1. Mold will lower MSH and MSH when low can increase gut permeability
         1. Vicious cycle…
         1. Inhalation can be another route for the microbial toxins
            1. Cell wall LPS &
            1. Mycotoxins
      1. Infectious Load vs. Toxic Load
         1. Infectious (all of these can affect the brain)
            1. HSV
            1. Mycoplasma
            1. Borrelia
            1. Bordetella
            1. Chlamydia
            1. Bartonella
            1. Babesia
            1. Sinus microbes
               1. Can cross cribriform plates
               1. Blood brain permeability leaks during inflammation
         1. Toxic Load
            1. Amyloid plaques in the brain are often protective/brain response to inflammation and infection
            1. Mycotoxins
            1. Other chemicals
            1. Women affected more than men and at earlier ages
               1. 10:1 female : male
               1. Testosterone decreases the immune response
               1. Many of these processes are autoimmune by nature
               1. High dose DHEA can decrease autoimmunity
               1. Dilution is the solution to pollution
                  1. Women are generally smaller than men and thus cannot handle a given toxic load as well as men can
               1. Women use a lot more personal chemicals; makeup etc.
               1. Work exposures;
                  1. Govt bldgs. Have a higher risk of mold than private bldgs.
                  1. Nail tech’s
                  1. Hair salons
                  1. Healthcare workers are exposed to many toxic and infectious exposures/agents
                  1. Some folks are more sensitive and are triggered sooner and/or by lower exposures than others
                     1. “canary in the coal mine”
                     1. More likely to have
                        1. autoimmunity
                        1. Neurodegenerative diseases
                        1. Cancer
         1. Approach to toxic load;
            1. Question folks, not about “mold exposure” but
               1. Leaky dishwasher, other area of the house
               1. Musty smell
               1. Bowed floorboards
               1. Basement flood hx
            1. Symptoms;
               1. Brain fog
                  1. Memory assimilation
                  1. Word finding
               1. Histamine reactions
                  1. Rash
                  1. Itch
                  1. Hive
               1. Cough/SOB/Sinus
               1. HA
               1. Gut
                  1. Heartburn
                  1. Diarrhea
                  1. Constipation     
               1. Excessive change in weight
               1. Excessive fatigue/exercise intolerance
               1. Problems with muscle twitches/fasciculations
               1. Neuropathies
            1. Good History
               1. Did illness come with change of environment?
               1. Other family members affected?
               1. Other family members with HA, etc.
            1. Visual Contrast online or in office
               1. 8% of folks with normal VCS can still have exposure
            1. Labs (no one test is diagnostic)
               1. VEGF
               1. MMP9
               1. TGFB1
               1. C4a
               1. C3a
               1. MSH
               1. Anti-Gliadin
               1. Anti-Cardiolipin
               1. Genetics less important, may show risk though
               1. Urinary Mycotoxins
                  1. Works best with Glutathione and/or
                  1. Sauna provocation
               1. Rule out other infections
            1. Detox options
               1. Usually glutathione depleted
                  1. SL liposomal
                  1. Oral-liposomal
                  1. Inhaled
                  1. Rectal
                  1. IV
               1. Phosphatidyl Choline
                  1. Membrane stabilization
                  1. IV
                  1. Brain issues
               1. Binders
                  1. CSM
                     1. Binds Ochratoxin A best
                  1. Charcoal
                     1. Great binder for endotoxins
                  1. Clay
                  1. Zeolite
                  1. Glycomannin
                  1. Citrus Pectin
                  1. Bamboo
               1. IR Sauna/sweat
               1. Epsom Salt baths
               1. Castor Oil packs
               1. Coffee enemas
               1. Hydrotherapy (hot then cold… alternating)
               1. Lymphatic massage
               1. Homeopathic drainage to open kidneys and liver
               1. Treat dysbiosis in gut
                  1. Oregano
                  1. Caprylic Acid
                  1. Antimicrobial herbs
                  1. Glutamine
                  1. Aloe
                  1. Licorice
                  1. Probiotics
                     1. Bifidobacter
                     1. Spore formers work great for endotoxemia
                     1. SIBO/SIFO sometimes don’t tolerate high lactobacillus
                        1. Spore formers works
                        1. A lot of presumed SIBO is actually SIFO
                        1. Nystatin can be helpful         
               1. Gut Motility can also be a problem with dysbiosis
         1. Bldg. inspection
            1. Inspectors are the gold standard
            1. HERTSMI2/ERMI are a pretty good second choice
            1. Certain red-flag organisms should be seen by an inspector, esp.
               1. Stachybotrys
               1. Chaetomium
            1. Real Time Labs Emma Test

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Dr. Raymond Oenbrink

Dr. Raymond Oenbrink DO is board certified by the American Osteopathic Board of Family Physicians (AOBFP) and the American Board of Addiction Medicine (ABAM). He specializes in complex and chronic illnesses such as Chronic Inflammatory Response Syndrome (CIRS).

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